Academic Stress Levels in Annual & Semester System: A Cross-Sectional Comparative Study on Students of Physiotherapy in Lahore, Pakistan

Physical Therapy in Pakistan has not yet been considered amongst the reputed professions due to the lack of awareness among the public. This being the very reason of the higher stress among the students studying physiotherapy is kept under consideration in this study. The main purpose of this study was to determine if the students of Annual system endure stress levels higher than those of Semester system. Also the aim was to determine which assessment system was more conducive for an effective learning & to acknowledge the major stressors among the DPT students along with their coping strategies. This study was a Comparative Cross-Sectional Study conducted in duration of 8 months. Data was collected from both male and female students of DPT who had completed 50% of their credit hours of the curriculum. The sample size calculated was found to be 343 (n=343). Exposure assessment included the International Stress Questionnaire which is most commonly used instrument for the evaluation of stress levels among students. The International Stress Questionnaire was administered into a group of 70 students from Public and Private Institutes for validation purpose. Thus 560 questionnaires were distributed among students amongst which only 384 were fully completed and thus included for the statistical analysis. Mean age of the students was found to be 21±1.34 years. Amongst 384 students, 292 were females and 92 were males.190 students were from Annual system i.e. Pass/Fail system and 194 had GPA system as their assessment system. Interpretations were done according to the standard way i.e. a score of 4 or less was supposed to be mild, 5-13 was moderate and 14 or more was severe. Amongst those from Annual system, 17 had mild, 139 had moderate and 34 had severe stress. Amongst 194 students from GPA system, 122 had mild and 72 had moderate stress whereas none of those reported to fall in the category of severe stress. Independent t test was applied to identify if there were significant differences between the two groups and the p value was found to be 0.00 i.e. highly significant. A forum should be developed to register all the students enrolled in Doctor of Physiotherapy every year encompassing all Institutes to prevent the biasness due to non-probability sampling method used to recruit sample

Enhanced solar light photocatalytic performance of Fe-ZnO in the presence of H2O2, S2O82−, and HSO5− for degradation of chlorpyrifos from agricultural wastes: Toxicities investigation

This study reported Fe doped zinc oxide (Fe-ZnO) synthesis to degrade chlorpyrifos (CPY), a highly toxic organophosphate pesticide and important sources of agricultural wastes. Fourier transform infrared, X-ray diffraction, scanning electron microscope, and energy-dispersive X-ray spectroscopic analyses showed successful formation of the Fe-ZnO with highly crystalline and amorphous nature. Water collected from agricultural wastes were treated with Fe-ZnO and the results showed 67% degradation of CPY by Fe-ZnO versus 39% by ZnO at 140 min treatment time. Detail mechanism involving reactive oxygen species production from solar light activated Fe-ZnO and their role in degradation of CPY was assessed. Use of H2O2, peroxydisulfate (S2O82−) and peroxymonosulfate (HSO5−) with Fe-ZnO under solar irradiation promoted removal of CPY. The peroxides yielded hydroxyl ([rad]OH) and sulfate radical ([Formula presented]) under solar irradiation mediated by Fe-ZnO. Effects of several parameters including concentration of pollutant and oxidants, pH, co-existing ions, and presence of natural organic matter on CPY degradation were studied. Among peroxides, HSO5− revealed to provide better performance. The prepared Fe-ZnO showed high reusability and greater mineralization of CPY. The GC-MS analysis showed degradation of CPY resulted into several transformation products (TPs). Toxicity analysis of CPY as well as its TPs was performed and the formation of non-toxic acetate imply greater capability of the treatment technology

Potential degradation of norfloxacin using UV-C/Fe2+/peroxides-based oxidative pathways

The removal of norfloxacin (NOR), a widely used pharmaceutical and emerging water pollutant, was studied using UV-C and Fe2+ catalyzed peroxides-based oxidative processes (e.g., UV-C/Fe2+/H2O2, UV-C/Fe2+/S2O8 2− and UV-C/Fe2+/HSO5 −) and compared with UV-C and UV-C/Fe2+. The UV-C and UV-C/Fe2+ degraded NOR to 38 and 55%. However, use of peroxides, i.e., H2O2, S2O8 2−, HSO5 − with UV-C and UV-C/Fe2+ promoted NOR %degradation to 75, 83, and 90% using [peroxides]0 = 50 mg/L, [Fe2+]0 = 1 mg/L, and [NOR]0 = 10 mg/L, respectively. The significant impact of peroxides on NOR degradation was due to their decomposition into ●OH and SO4 ●− which showed high activity towards NOR degradation. The ●OH and SO4 ●− formation from peroxides decomposition and their contribution in NOR degradation was verified by different scavenger studies. Among the UV-C/Fe2+/peroxides processes, UV-C/Fe2+/HSO5 − showed better performance. The changing concentrations of peroxides, Fe2+, and NOR affected degradation of NOR. The use of different pH and inorganic anions also influenced NOR degradation. The degradation pathways of NOR were established and analyzed acute as well as chronic toxicities of NOR and its DPs

Visible light driven doped CeO2 for the treatment of pharmaceuticals in wastewater: A review

The high-level contamination of pharmaceuticals in aquatic environment, and their toxicities is a serious issue. This review highlights the use of ceria photocatalyst for treatment of pharmaceuticals. Cerium oxide (CeO2) with high oxygen storage, ecofriendly properties, reusability, and photostability contrary to other metal oxides photocatalysts is reportedly a better choice. However, ceria with high band gap energy show photoactivity mainly under UV light. This review highlights pharmaceuticals contamination in water, their contamination level, and toxicities and properties of CeO2 and different approaches used for extending photoactivity of CeO2 under visible irradiation. Metals and non-metals doping is found to promote greatly photoactivity of CeO2 under visible irradiation by narrowing band gap, shift in absorption edge to visible region, crystal defects and yield of oxygen vacancy, lower recombination of conduction band electrons and valence band holes and increasing surface area. The visible irradiation of CeO2 is found to produce hydroxyl radical (OH) and superoxide radical (O2 –) which contribute in pharmaceuticals degradation. The electron paramagnetic resonance spectroscopy and radical scavenger studies confirmed the formation of reactive oxygen species from CeO2 photoactivation. Doping was found to incorporate into the lattice of CeO2 and improve reusability and stability of CeO2 photocatalyst. The suggested mechanisms involved in the treatment of pharmaceuticals through OH and O2 – is discussed. Furthermore, the outlook and future challenges in the use CeO2 for photocatalytic degradation of pharmaceuticals and other organic pollutants are evaluated

Relationship between Kinesiophobia, Fall Risk and Activity Level among Elderly Females after Total Knee Arthroplasty

Objective: To determine the effect of Mulligan’s Mobilization on unilateral tibiofemoral osteoarthritis. The objective of the study was to evaluate co-relation between fall risk, kinesiophobia, and physical- activity level among elderly females after one year of TKA. Methodology: This study was a cross-sectional survey conducted on females who had their Total Knee arthroplasty from Ghurki Trust & Teaching Hospital and Punjab Medical Centre, Lahore. Data was collected from 200 (n) elderly females who had undergone their Total Knee Arthroplasty at least one year before the study was conducted. Fall risk (Berg Balance Scale), fear of movement (Tampa Scale of Kinesiophobia), and physical activity (IPAQ) were the key outcome measures. Results: Pearson correlation determined higher levels of association between fall risk, fear of movement and physical activity. Higher the berg balance score, lower the score of Kinesiophobia i.e. negatively significant correlation; r (198) = -.54, p=0.00. Higher berg balance scores were also found to be positively related to higher minutes of low, moderate and vigorous exercise per week. Kinesiophobia was found to be negatively significant for physical activity of low, moderate and vigorous intensity i.e. r (198) = -.11, p= .01, r (198) = -.03, p=.00 and r (198) = -.07, p= .02 respectively.   Conclusion: A significant negative correlation was observed between fall risk and Kinesiophobia. Moreover, a significant positive correlation was observed between fall risk and physical activity in elderly females who have had TKA. Key words: Berg balance scale, fall risk, kinesiophobia, Total Knee Arthroplast

Immunological axis of berberine in managing inflammation underlying chronic respiratory inflammatory diseases

© 2020 Inflammatory responses play a remarkable role in the mechanisms of acute and chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis and lung cancer. Currently, there is a resurgence in the use of drugs from natural sources for various ailments as potent therapeutics. Berberine, an alkaloid prominent in the Chinese traditional system of medicine has been reported to exert therapeutic properties in various diseases. Nevertheless, the number of studies focusing on the curative potential of berberine in inflammatory diseases involving the respiratory system is limited. In this review, we have attempted to discuss the reported anti-inflammatory properties of berberine that function through several pathways such as, the NF-κB, ERK1/2 and p38 MAPK pathways which affect several pro-inflammatory cytokines in the pathophysiological processes involved in chronic respiratory diseases. This review would serve to provide valuable information to researchers who work in this field and a new direction in the field of drug discovery with respect to respiratory diseases

The Karachi intracranial stenosis study (KISS) Protocol: an urban multicenter case-control investigation reporting the clinical, radiologic and biochemical associations of intracranial stenosis in Pakistan.

Background: Intracranial stenosis is the most common cause of stroke among Asians. It has a poor prognosis with a high rate of recurrence. No effective medical or surgical treatment modality has been developed for the treatment of stroke due to intracranial stenosis. We aim to identify risk factors and biomarkers for intracranial stenosis and to develop techniques such as use of transcranial doppler to help diagnose intracranial stenosis in a cost-effective manner. Methods/Design: The Karachi Intracranial Stenosis Study (KISS) is a prospective, observational, case-control study to describe the clinical features and determine the risk factors of patients with stroke due to intracranial stenosis and compare them to those with stroke due to other etiologies as well as to unaffected individuals. We plan to recruit 200 patients with stroke due to intracranial stenosis and two control groups each of 150 matched individuals. The first set of controls will include patients with ischemic stroke that is due to other atherosclerotic mechanisms specifically lacunar and cardioembolic strokes. The second group will consist of stroke free individuals. Standardized interviews will be conducted to determine demographic, medical, social, and behavioral variables along with baseline medications. Mandatory procedures for inclusion in the study are clinical confirmation of stroke by a healthcare professional within 72 hours of onset, 12 lead electrocardiogram, and neuroimaging. In addition, lipid profile, serum glucose, creatinine and HbA1C will be measured in all participants. Ancillary tests will include carotid ultrasound, transcranial doppler and magnetic resonance or computed tomography angiogram to rule out concurrent carotid disease. Echocardiogram and other additional investigations will be performed at these centers at the discretion of the regional physicians. Discussion: The results of this study will help inform locally relevant clinical guidelines and effective public health and individual interventions

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care